Or-Rashid Mohammad Haroon, Sultana Anjuman, Khanduker Nabila, Ony Tarik Alam, Hossain Md Mosharraf, Rahman Junaidur, Chowdhury Mahmud Zaman, Ahmed Wasih Uddin, Uddin Md Nashir, Uzzaman Mohammad Sohel-
Department of Surgery, Dhaka Medical College and Hospital, Dhaka 1000, Bangladesh.
Department of Obstetrics and Gynaecology, Mugda Medical College, Dhaka 1214, Mugda, Bangladesh.
World J Radiol. 2025 May 28;17(5):106102. doi: 10.4329/wjr.v17.i5.106102.
Obstructed defecation syndrome (ODS) is a subtype of constipation that is considered one of the major pelvic floor dysfunctions affecting the aging population, particularly women over 50 seeking medical care. The condition is characterized by the urge to defecate but an impaired ability to expel the fecal bolus. ODS is associated with various anorectal abnormalities, which are not always apparent during a standard physical examination, requiring specialized imaging techniques for proper diagnosis.
To study the distribution of causes of ODS in patients with chronic constipation by magnetic resonance defecography (MRD).
This observational study evaluated the causes of ODS in 57 patients with chronic constipation who presented to Bangabandhu Sheikh Mujib Medical University between July 2020 and June 2021. After obtaining institutional review board approval and informed consent, patients underwent history taking, physical exams, and relevant investigations. ODS was diagnosed using Rome III criteria, with colonoscopy ruling out organic causes. Standard MRD was performed in different phases, and images were analyzed by expert radiologists and reported in a standardized format.
Pelvic floor descent and anorectal junction descent were the most frequent findings, each present in 94.7% of cases. Rectocele was observed in 78.9% of patients, while vaginal or uterine prolapse was seen in 59.4% of females. Less common abnormalities included paradoxical contraction (7%), and there were no cases of sigmoidocele. Functional measurements showed significant differences in pelvic floor dynamics between rest and defecation, particularly in the H-line, M-line, and descent of pelvic organs ( < 0.05).
Pelvic floor descent and anorectal descent were the most common findings in patients suffering from ODS, followed by rectocele. Younger females (< 30 years) were most affected.
排便障碍综合征（ODS）是便秘的一种亚型，被认为是影响老年人群，尤其是50岁以上寻求医疗护理的女性的主要盆底功能障碍之一。该病症的特征是有排便冲动，但排出粪块的能力受损。ODS与各种肛肠异常有关，这些异常在标准体格检查中并不总是明显的，需要专门的成像技术才能进行正确诊断。
通过磁共振排粪造影（MRD）研究慢性便秘患者中ODS的病因分布。
这项观察性研究评估了2020年7月至2021年6月期间在班加班杜·谢赫·穆吉布医科大学就诊的57例慢性便秘患者的ODS病因。在获得机构审查委员会批准和知情同意后，对患者进行病史采集、体格检查和相关检查。使用罗马Ⅲ标准诊断ODS，结肠镜检查排除器质性病因。在不同阶段进行标准MRD，由专家放射科医生分析图像并以标准化格式报告。
盆底下降和肛管直肠交界下降是最常见的发现，各占病例的94.7%。78.9%的患者观察到直肠膨出，59.4%的女性观察到阴道或子宫脱垂。较不常见的异常包括矛盾性收缩（7%），没有乙状结肠膨出病例。功能测量显示休息和排便时盆底动力学有显著差异，特别是在H线、M线和盆腔器官下降方面（<0.05）。
盆底下降和肛管直肠下降是ODS患者最常见的发现，其次是直肠膨出。年龄较小的女性（<30岁）受影响最大。
